Performance-based incentive (PBI) schemes are gaining traction in developing country health systems. PBI programs are one strategy for increasing the volume, and improving the quality, of health services, and complement investments in inputs.

Improving quality of care has been the focus of PBI schemes in high-income countries (HICs), but because many low- and middle-income countries (LMICs) struggle with low utilization of critical services, the primary objective of most PBI schemes in LMICs has been to boost service use. But more programs are focusing their efforts on improving quality of care.

This paper provides guidance on developing stronger linkages between quality improvement and PBI in LMICs, by reflecting on current efforts in both HICs and LMICs and focusing mostly on supply-side schemes.

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